Thank You for choosing us as your primary care provider. We are committed to providing you with quality and affordable health care.

Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we have been advised to develop this payment policy.
Please read it, ask us any questions you may have, and sign in the space provided. A copy will be provided to you upon request.

We participate in most insurance plans, including Medicaid. If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments deductibles from patient can be considered fraud. Please help us in upholding the law by paying co-payment at each visit.

Please be aware that some-and perhaps all-of the services you receive may be no covered or not considered reasonable or necessary by Medicaid or other insurers. You must pay for these services in full at time of visit.

All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If you fail to provide us with correct insurance information in a timely manner, you be responsible for the balance of claim..

We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contact between you and your insurance company; we are not party to contract.

If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help your maximum benefits. If your insurance company does not pay your claim in 45 day, the balance will automatically be billed to you.

If your account is over 90 days past due , you will receive letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated .Please be aware that if balance remains unpaid, we may refer you account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail you have 30 days to find alternative medical care. During that 30 – day period, our physician will only be able to treat you on an emergency basis.
Returned checks and balances older than 30 days will be subject to additional collection fees and interest charges of 1.5% per month .ANY ATTORNEY OR COLLECTION FEES INCURRED DUE TO DELINQUENCY IN PAYMENT WILL ALSO BE CHARGED TO THE PATIENT.

Our policy is to charge $ 25.00 for missed appointments not canceled within a reasonable amount of time. These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment.
There is a $ 40 fee for return checks.

Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area.Thank You for understanding our payment policy. Please let us know if you have any questions or concerns.